A transgender woman complained that the Ontario Health Insurance Plan (OHIP) had improperly refused her application for prior approval for breast reconstruction surgery. The woman explained that due to medical treatment she had undergone as an adolescent, she required additional reconstructive surgery that would not normally be covered for sex reassignment. Our Office made inquiries with the Ministry, and also spoke with the woman’s surgeon. The surgeon then submitted a new application with additional information, which was approved, with the Ministry specifying that any medically necessary procedures would be covered.